The antibody-drug conjugate (ADC) market in non-small-cell lung cancer (NSCLC) is poised for substantial growth, with GlobalData forecasting the market will exceed $3.9 billion by 2032 across seven major markets, representing a compound annual growth rate of 6.8%. This projection comes despite the relatively late entry of ADCs into the NSCLC treatment landscape, with the first approval occurring only in 2022.
Market Leaders and Competitive Landscape
AstraZeneca and Daiichi Sankyo's Datroway (datopotamab deruxtecan) is expected to dominate the NSCLC ADC market, accounting for over 32.6% of sales and generating more than $1.2 billion by 2032. The drug is currently being evaluated in five Phase III clinical trials as a first-line therapy in combination with immune checkpoint inhibitors (ICIs), bispecific antibodies, and epidermal growth factor receptor inhibitors.
Pfizer's sigvotatug vedotin follows closely behind, projected to capture 27.3% market share with over $1 billion in sales by 2032. AstraZeneca is also assessing Datroway's potential in adjuvant settings in combination with its own ICI rilvegostomig in the TROPION-Lung12 trial.
Pipeline Activity and Strategic Focus
The ADC development pipeline in NSCLC demonstrates significant activity, with 29 Phase III ongoing global clinical trials sponsored by major pharmaceutical companies, including Merck & Co., AbbVie, AstraZeneca, and Daiichi Sankyo. AstraZeneca and Daiichi Sankyo lead with six Phase III trials, while Merck follows with four trials.
"Trophoblast cell surface antigen 2-directed ADCs like Merck's and Gilead's Trodelvy (sacituzumab govitecan), HER2-targeting ADC Enhertu, and HER3-directed ADCs such as Datroway are being explored across broad NSCLC populations," notes Biswajit Podder, PhD, Oncology and Hematology Analyst at GlobalData.
Shift Toward Earlier Treatment Lines
Companies are increasingly focusing on first-line and early disease settings, mirroring the trajectory of targeted therapies like AstraZeneca's Tagrisso (osimertinib) and immunotherapies like Merck's Keytruda (pembrolizumab). While Enhertu and AbbVie's Emrelis (telisotuzumab vedotin) have received approval, and Datroway is in the pre-registration stage for second-line treatment, the industry trend points toward earlier intervention.
Merck is evaluating its ADC Giatelai (sacituzumab tirumotecan) in adjuvant and maintenance settings, further demonstrating the push toward earlier treatment phases.
Manufacturing Expansion and Market Challenges
To meet rising ADC demand, Lonza and AstraZeneca are expanding their manufacturing capacities in Switzerland and the US, respectively, with facilities expected to be operational by 2028 and 2029.
Despite the promising outlook, ADCs face several challenges in NSCLC treatment. "ADCs face several challenges, including resistance to the payload, narrow therapeutic window, molecular heterogeneity, and toxicity, such as interstitial lung disease and thrombocytopenia," Podder explains.
However, he notes that "by identifying novel targets, developing bispecific antibodies, engineering better linkers, using multiple different payloads on one ADC, and identifying suitable patient populations using biomarkers, ADCs have the potential to replace chemotherapy, improve safety and efficacy, and prevent resistance mechanisms by combining ADCs with other treatment modalities such as immunotherapy."
The NSCLC ADC market's evolution reflects the broader transformation in oncology treatment, where precision medicine approaches are increasingly moving toward earlier disease stages to maximize therapeutic benefit.
